Mental Illness

Debate over the true nature of mental illness is polarized between those arguing for a social and those arguing for a physiological etiology. Psychiatry finds itself at the center of this debate, its status called into question by those who claim that to treat mental disorder as a physiological ailment is to mask the social origin of the illness.

In The Social Nature of Mental Illness, Len Bowers offers an objective and philosophical critique of the theories of mental illness as a social construct. His purpose is to examine the rationality of these theories, what they might mean, and in which cases they are to be accepted or rejected. Previous work on this issue has concentrated upon empirical evidence. All that has been generated from this are opposing interpretations of the data, rather than solutions. This book examines the common ground between the apologists for and critics of psychiatry, and discusses how debate on this issue affects research into and treatment of mental illness. Len Bowers argues that many of the assertions made about the social nature of mental illness care misguided or wrong, but he concludes that they cannot be wholly rejected.

Psychologists have attempted to define psychological abnormality in a number of ways including statistical infrequency and deviation from social norms. Susan Cave discusses and compares some of the attempts made and examines their limitations.

Tessler and Gamache provide substantial research on the impact of mental illness on the family through interviews conducted with hundreds of family members between 1989 and 1997. According to the authors, how families experience the mental illness of a relative depends on many social factors, including how public mental health services are organized and financed, and whether families feel judged or supported by professionals.

This work is the most comprehensive volume to focus on new directions in professional practice with families of people with mental illness. It offers a multidisciplinary systems-oriented examination of theory, research, and practice in the area. Unique features include a consideration of life-span and family system and subsystem perspectives, as well as the inclusion of powerful personal accounts of family members. It is written from the perspective of a competence paradigm for clinical practice, which offers a constructive alternative to the more prevalent pathology models of the past.

In this vivid and thoughtful study, David Karp chronicles the experiences of the family members of the mentally ill, and how they draw "boundaries of sympathy" to avoid being engulfed by the day-to-day suffering of a loved one. Working from sixty extensive interviews, the author reveals striking similarities in the experiences of caregivers: the feelings of shame, fear, guilt and powerlessness in the face of a socially stigmatized illness; the frustration of navigating the complex network of bureaucracies that govern the mental health system; and most of all, the difficulty negotiating an "appropriate" level of involvement with the mentally ill loved one while maintaining enough distance for personal health. Throughout, Karp sensitively explores the overarching question of how people strike equilibrium between reason and emotion, between head and heart, when caring for a catastrophically ill person. The book concludes with a critical look at what it means to be a moral and caring person at the turn of the century in America, when powerful cultural messages spell out two contradictory imperatives: pursue personal fulfillment at any cost and care for the family at any cost. An insightful, deeply caring look at mental illness and at the larger picture of contemporary values, The Burden of Sympathy is required reading for caregivers of all kinds, and for anyone seeking broader understanding of human responsibility in the postmodern world.

Psychopathology is a concise introduction to the major classes of adult mental illness. Beginning with a historical overview, the authors consider how mental abnormality can be defined, reviewing the main classification systems and the issues raised in classification and diagnosis. Schizophrenia, mood disorders, anxiety and eating disorders are explored with a description of the main features of illness, and the signs, symptoms and effects of behavior for the patient as well as the impact on relatives and friends.

When madness is intolerable for sufferers, how do professional carers remain sane? Psychiatric institutions have always been places of fear and awe. Madness impacts on family, friends and relatives, but also those who provide a caring environment, whether in large institutions of the past, or community care in the present. This book explores the effects of the psychotic patient's suffering on carers and the culture of psychiatric services. Suffering Insanity is arranged as three essays. The first concerns staff stress in psychiatric services, exploring how the impact of madness demands a personal resilience as well as careful professional support, which may not be forthcoming. The second essay attempts a systematic review of the nature of psychosis and the intolerable psychotic experience, which the patient attempts to evade, and which the carer must confront in the course of daily work. The third essay returns to the impact of psychosis on the psychiatric services, which frequently configure in ways which can have serious and harmful effects on the provision of care. In particular, service may succumb to an unfortunate schismatic process resulting in sterile conflict, and to an assertively scientific culture, which leads to an unwitting depersonalisation of patients. Suffering Insanity makes a powerful argument for considering care in the psychiatric services as a whole system that includes staff as well as patients; all need attention and understanding in order to deliver care in as humane a way as possible. All those working in the psychiatric services, both in large and small agencies and institutions, will appreciate that closer examination of the actual psychology and interrelations of staff, as well as patients, is essential and urgent.

Millions of people have listened to John H. Lienhard's radio program "The Engines of Our Ingenuity." In this fascinating book, Lienhard gathers his reflections on the nature of technology, culture, and human inventiveness. The book brims with insightful observations. Lienhard writes that the history of technology is a history of us--we are the machines we create. Thus farming dramatically changed the rhythms of human life and redirected history. War seldom fuels invention--radar, jets, and the digital computer all emerged before World War II began. And the medieval Church was a driving force behind the growth of Western technology--Cistercian monasteries were virtual factories, whose water wheels cut wood, forged iron, and crushed olives. Lienhard illustrates his themes through inventors, mathematicians, and engineers--with stories of the canoe, the DC-3, the Hoover Dam, the diode, and the sewing machine. We gain new insight as to who we are, through the familiar machines and technologies that are central to our lives.

As case management has replaced institutional care for mental health patients in recent decades, case management theory has grown in complexity and variety of models. But how are these models translated into real experience? How do caseworkers use both textbook and practical knowledge to assist clients with managing their medication and their money? Using ethnographic and historical-sociological methods, Meds, Money, and Manners: The Case Management of Severe Mental Illness uncovers unexpected differences between written and oral accounts of case management in practice. In the process, it suggests the possibility of small acts of resistance and challenges the myth of social workers as agents of state power and social control.

This state-of-the-art, multi-disciplinary reference is the first to assess the empirical research and conceptual frameworks for understanding the mental health needs and services use of the ethnic elderly. Leading scholars, researchers, and clinicians in gerontology, epidemiology, psychiatry, psychology, sociology, anthropology, nursing, and social work appraise varying approaches, the demographics, the mental health status and service use of the ethnic elderly, and issues in the diagnosis, treatment, and mental health service delivery for the ethnic aged: for African Americans, American Indians, Asian and Pacific Islander Americans, and Hispanic/Latino Americans. This unique handbook is a valuable resource and text for students, teachers, and professionals in a broad array of fields and settings.

"This handbook brings together crucial information related to mental illness among black Americans by examining the impact of social structures and conditions on the mental health of blacks." Choice